Position: Care Navigator

Location: Wisconsin but 100% Remote

Duration: 6 Month CTH

Start Date: ASAP

Description:

Positions in this function includes those responsible for initial triage of members, administrative intake of members or managing the admission/discharge information post-notification, working with hospitals and the clinical team. Includes managing incoming calls, managing requests for services from providers/members, providing information on available network services and transferring members as appropriate to clinical staff. Manages the referrals process, processes incoming and outgoing referrals, and prior authorizations. This function includes intake, notification and census roles. *Employees in jobs labeled with ‘SCA’ must support a government Service Contract Act (SCA) agreement.

As part of our clinical support team, you will be a key component in customer satisfaction and have a responsibility to make every contact informative, productive and positive. Take this opportunity to work with a Fortune 6 industry leader.

Primary Responsibilities:

• Manage the intake of members or the admission/discharge information post notification
• Work with hospitals, clinics, facilities and the clinical team to manage requests for services
• Manage the referral process, processing incoming and outgoing referrals and prior authorizations, including intake, notification and census roles
• Resolve inquiries from members and/or providers
• applies knowledge/skills to a range of moderately complex activities.
• Demonstrates great depth of knowledge/skills in own function.
• Sometimes acts as a technical resource to others in own function.
• Proactively identifies solutions to non-standard requests.
• Solves moderately complex problems on own.
• Works with team to solve complex problems.
• Plans, prioritizes, organizes and completes work to meet established objectives.
• May coordinate work of other team members.

Job Type: Full-time

Pay: $17.00 - $19.00 per hour

Benefits:

• Dental insurance
• Health insurance
• Vision insurance

Schedule:

• 5x8
• 8 hour shift
• Day shift
• Monday to Friday
• No weekends

Application Question(s):

• Do you have experience with Metrics/KPIS? If so, what were they?
• Are you fully vaccinated against COVID-19? This is required.
• Do you currently live in Wisconsin? This is required.

Experience:

• Healthcare: 2 years (Preferred)
• Call center: 2 years (Preferred)

Work Location: Remote

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